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Non-Drug Treatment Alternatives

In this section, Dr. Alvin E. Lake III and Robert Hamel, P.A.-C explore the efficacy of various non-drug treatments for headache and pain.

Are there non-drug alternatives?

Drugs are not the only means of effectively treating head pain. For many people with intermittent migraine and tension-type headaches, the consistent practice of behavioral methods can actually reduce the intensity and frequency of attacks. For others, behavioral treatment may primarily be of value in creating a sense of well-being, coping with the stress created by the headache, or helping the headache sufferer continue to function. For frequent and severe headaches, behavioral methods are usually combined with drug therapy and may lead to better headache control than would be the case with either type of treatment alone.

Some behavioral methods, such as biofeedback, relaxation training, and cognitive-behavioral therapy, have demonstrated their effectiveness in over 25 years of rigorous research and well over 100 experimental studies in these combined areas. Others, such as aerobic exercise, sleep regulation, dietary regulation, and smoking cessation, make sound physiological sense and are supported by clinical experience. All of these behavioral approaches share the advantages of minimal if any negative side effects and negligible cost once the techniques are learned and practiced regularly.

How common are alternative medicine therapies?

It is possible that between 30-40% of adults in the United States seek nonmedical alternative treatment at least once during the year. Annual expenditures for alternative treatment are now over $27 billion. Individuals may choose alternate treatments because of their dissatisfaction with conventional medicine, because they view alterative treatments as “safer,” or “more natural,” or because they simply get more personal attention from an alternative health care therapist.

Have alternative medicine therapies been “tested”?

Randomized controlled trials of alternative treatments, such as acupuncture, chiropractic, and massage, are now underway to assess the value of these practices for treating daily headache or neck pain. Placebo-controlled trials are more difficult for therapies such as acupuncture and chiropractic.

Some alternative practitioners have resisted randomized clinical trials because of what is perceived to be the disruption of the “therapeutic and holistic milieu.” However, standardized studies are required before an alternative treatment for head and neck pain can be considered safe, scientifically valid, and beneficial.

Summary

Many who suffer from problem headaches can benefit significantly from behavioral, nonpharmacologic treatment. These approaches do require a certain amount of effort and a "take charge" attitude. The best chance for success probably comes with making use of all appropriate behavioral techniques, in combination with a sound medication program.